| Dauphin Island Medical Group Llc | |
|
1008 Alabama Ave Dauphin Island AL 36528-4340 | |
| (843) 424-4818 | |
| Not Available |
| Full Name | Dauphin Island Medical Group Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1008 Alabama Ave, Dauphin Island, Alabama |
| Authorized Official Name and Position | Tessie O'quinn (CO OWNER) |
| Authorized Official Contact | 2513132115 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dauphin Island Medical Group Llc 1008 Alabama Ave Dauphin Island AL 36528-4340 Ph: () - | Dauphin Island Medical Group Llc 1008 Alabama Ave Dauphin Island AL 36528-4340 Ph: (843) 424-4818 |
| NPI Number | 1114639770 |
|---|---|
| Provider Enumeration Date | 12/14/2022 |
| Last Update Date | 06/20/2023 |
| Medicare PECOS PAC ID | 2062873169 |
|---|---|
| Medicare Enrollment ID | O20230807000350 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114639770 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Tessie L Oquinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235542713 PECOS PAC ID: 4385865187 Enrollment ID: I20141020002486 |
| Provider Name | Jun Yoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477815165 PECOS PAC ID: 0345551784 Enrollment ID: I20160519000816 |
| Provider Name | Marcie Mcphillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912409053 PECOS PAC ID: 7618220047 Enrollment ID: I20181031002369 |
Island Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1008 Alabama Avenue, Dauphin Island, AL 36528 Phone: 251-861-3050 Fax: 251-861-3055 |